CMS has proposed a new timeline for implementation of meaningful use for its Medicare and Medicaid electronic health record (EHR) incentive programs, but family physicians still need to stay on task with meaningful use (MU) stage two preparations, according to Jason Mitchell, M.D., the AAFP's director of health information technology.
According to information posted on the CMS website(www.cms.gov) on Dec. 6, the revised timeline would extend stage two through 2016 and, for physicians who have completed at least two years in MU stage two, push the beginning of stage three to 2017.
"This doesn't affect the implementation of stage two at all," Mitchell told AAFP News Now. "It delays stage three by a year, but all of the things that are required to make family physicians compliant with stage two of meaningful use remain exactly the same."
According to CMS and the Office of the National Coordinator for Health Information Technology (ONC), the changes would
- allow more analysis of feedback from stakeholders on MU stage two progress and outcomes,
- provide additional data on stage two adoption and measure calculations,
- give stakeholders more time to consider potential stage three requirements, and
- ensure that developers have ample time to create and distribute certified EHR technology that incorporates lessons learned about usability and customization before stage three begins.
"The phased approach to program participation helps providers move from creating information in stage one to exchanging health information in stage two to focusing on improved outcomes in stage three," said Robert Tagalicod, director of CMS' Office of E-Health Standards and Services, and Jacob Reider, M.D., acting national coordinator for Health Information Technology.
"This new proposed timeline tracks ongoing conversations we at CMS and ONC have had with providers, consumers, health care associations, EHR developers and other stakeholders in the health care industry."
But Mitchell cautioned physicians against reading too much into the proposed new timeline. He acknowledged that pushing MU stage three back at least another year would allow physicians, hospitals, and EHR vendors to better focus on being successful with MU stage two.
However, he added, "Stage two is turning out to be a tremendous amount of work for all stakeholders, and there is still a significant risk that some physicians will choose to jump off the figurative meaningful use escalator."
Mitchell pointed to the AAFP's ongoing concerns with MU stage two that center on issues such as quality measures; clinical decision support; secure messaging; care transitions and care summaries; and requirements that users, including patients, can view and download all of that information.
"The Academy will continue to push CMS to make adjustments to stage two that will move health care forward but that will allow some flexibility and breathing room for family physicians as they work to meet the requirements," Mitchell added.
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